Dr. Brian Elliott shares how the latest Arsenal Foot™ Plate families broaden procedural options and complement existing Enovis foot and ankle solutions.

Which new Arsenal Foot™ Plate are you most excited to use and why?

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Arsenal Foot™ Plating System
Fifth Met Hook Plate

I'm actually very excited about the fifth metatarsal base hook plate, in part because hook plates, although they're sometimes necessary and can be very effective, don't always fit very well. They're often clunky, and you can have trouble with the tines.

Unfortunately, sometimes you have fractures that aren't large enough to hold a screw, and that's where a hook plate can be very effective.

I love that with this Fifth Met Hook Plate, you can reduce the fracture and then pin it. After that, everything is cannulated, so it really takes the fiddle factor out of the procedure. With the cannulated system, you can drill for the tines on the back of the plate, and they seem to go into place very easily.

It's not a procedure where you always need to fix these fractures, but when you do, it can sometimes be very difficult. So I'm very excited about this because it really fills a gap.

Which Enovis products pair well with the new Arsenal Foot™ Plates in your practice?

I do a lot of midfoot fusions, so the Arsenal Foot™ Joint Prep Kit pairs very well with these plates. I think it's a very good system. In hospitals, the osteotomes and curettes get used repeatedly, so these prep kits are super helpful.

Specifically, if you're doing a talonavicular (TN) fusion, a calcaneocuboid fusion, or any type of midfoot or rearfoot fusion, the Joint Prep Kit is very effective and helps improve efficiency.

What do you like most about the Arsenal Foot™ Plating System?

I like that it's all Type II Anodized Titanium Alloy. Titanium is very strong, but can be bent when needed. The plates also have a low profile.

I'm very excited about the spanning Medial Column Plate because, although you don't have to perform spanning medial column fusions very often, when you do, it's a difficult procedure. It's nice to have a plate that contours well and fits beneath the tibialis anterior tendon.

I really like the way the spanning Medial Column Plate contours. I also think it pairs well for procedures like Charcot reconstruction. If you want to place a beam, the plate accommodates the beam really well.

Overall, there are lots of options, excellent contours, and I'm very excited about that particular plate as well.

Where do you see the new Arsenal Foot™ Plates fitting into your practice?

A triple arthrodesis is a very common procedure for me, and I like the idea of a TN fusion plate that's specifically designed for that joint. I definitely see this TN Fusion Plate fitting well into my practice.

I also use compression staples quite a bit, especially across the calcaneocuboid joint, so these plates complement that approach nicely in a triple arthrodesis. I can definitely see them complementing my current construct for TN fusion.

I also use these types of plates when I'm performing metatarsus adductus reconstruction in the midfoot. I'll often use a combination of plates and compression staples—typically plating for the osteotomies, more commonly in the fourth and fifth metatarsals, and compression staples throughout the midfoot for the arthrodesis.

So these plates work well for the osteotomy portion of the procedure, while the compression staples are used for the arthrodesis. I think the plates are very helpful for that application as well. In fact, I've already been using the 2.2 plates for that exact indication.

Is there anything else about the Arsenal Foot™ Plating System that stands out to you?

I think people will be surprised by the Fifth Met Hook Plate—and I think they'll want it for other applications as well.

I'm really excited about it because I can't tell you how many times I've been in a case where the plate just doesn't fit. The way this plate is designed, with the targeting device that lets you reduce the fragment, place the K-wire, and then have everything fit over the wire, really streamlines the procedure. I'm looking forward to using it.

Are there any other Arsenal Foot™ plates you're particularly excited to use?

One other plate I'm looking forward to using is the Cuboid Fracture Plate. I treat a number of cuboid fractures, and this plate has a very low profile while also offering excellent variable-angle capability.

That can be a difficult procedure when you're placing screws, so having a low-profile plate with variable-angle fixation and a strong locking mechanism is a real advantage. I really like the way the screws lock.

I've used other systems where very thin plates rely on thread-cutting locking technology, and I don't think the locking is as strong. Sometimes those screws can loosen. I'm really looking forward to trying this system because I think it's going to perform much better in those challenging cases.

* Dr. Brian Elliott is a paid consultant of Enovis.